Medical-Surgical Nursing: Endogenous Cortisol and Hormone Replacement

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What is the primary reason for patients to wear a medical identification (Medic Alert) bracelet?

To monitor their hormone levels

To track their corticosteroid replacement doses

To alert others of their inability to respond to stressors (correct)

To identify their medical allergies

What is the purpose of teaching patients to adjust their corticosteroid replacement in accordance with stress levels?

To prevent acute adrenal insufficiency (correct)

To minimize the effects of extreme temperatures

To manage emotional situations

To reduce the risk of infections

Why do patients need to avoid exposure to extreme temperatures?

To reduce the risk of acute adrenal insufficiency (correct)

To minimize the risk of emotional distress

To prevent dehydration

To prevent infections

What is the primary role of caregivers in the management of adrenal insufficiency?

Monitoring for signs of acute adrenal insufficiency (D) Signup and view all the answers

What is the likely outcome if a patient with adrenal insufficiency is unable to adjust their corticosteroid replacement in accordance with stress levels?

Acute adrenal insufficiency (D) Signup and view all the answers

Why may patients need lifetime hormone replacement therapy?

Because of their lack of endogenous cortisol (C) Signup and view all the answers

What is the recommended action for patients who are unable to adjust their corticosteroid replacement or experience weakness, fainting, fever, or nausea and vomiting?

Contact their healthcare provider (HCP) immediately (B) Signup and view all the answers

What is the primary goal of interventions in patients with Cushing syndrome?

To alleviate signs and symptoms of hormone and drug toxicity (A) Signup and view all the answers

What is a crucial aspect of monitoring in patients with Cushing syndrome?

Regularly assessing for signs of thromboembolic phenomena (A) Signup and view all the answers

What is a potential emotional challenge that patients with Cushing syndrome may face?

Potentially distressing changes in appearance, such as truncal obesity and bruising (B) Signup and view all the answers

What is a potential complication of Cushing syndrome that nurses should monitor for?

Cardiovascular disease and infection (A) Signup and view all the answers

What is a reassurance that nurses can provide to patients with Cushing syndrome?

The physical changes and much of the emotional lability will resolve when hormone levels return to normal (A) Signup and view all the answers

What is an essential aspect of nursing care in patients with Cushing syndrome undergoing surgical treatment?

Including both preoperative and postoperative care (D) Signup and view all the answers

What is the primary goal of interprofessional management for a patient with Cushing syndrome?

To normalize hormone secretion (C) Signup and view all the answers

What is a key aspect of assessing patients with Cushing syndrome?

Assessing for signs and symptoms of hormone and drug toxicity, as well as complicating conditions (D) Signup and view all the answers

What is the standard treatment for a pituitary adenoma?

Transsphenoidal surgical removal of the pituitary tumor (C) Signup and view all the answers

For patients with ectopic ACTH-secreting tumors, what is the recommended treatment?

Surgical removal of the tumor (A) Signup and view all the answers

What is the purpose of administering ketokonazole and mitotane to patients with Cushing syndrome?

To inhibit corticosteroid synthesis (B) Signup and view all the answers

What is the term for the use of drugs to inhibit adrenal function in patients with Cushing syndrome?

Medical adrenalectomy (A) Signup and view all the answers

Why may patients with Cushing syndrome require adrenalectomy?

To treat adrenal tumors or hyperplasia (B) Signup and view all the answers

What is the goal of nursing management for patients with Cushing syndrome?

To relieve symptoms and avoid serious complications (C) Signup and view all the answers

What is the primary cause of endogenous Cushing syndrome in approximately 85% of cases?

ACTH-secreting pituitary tumor (B) Signup and view all the answers

What is the typical distribution of fat in patients with Cushing syndrome?

Centripetal obesity (D) Signup and view all the answers

Which of the following is a symptom of mineralocorticoid excess in Cushing syndrome?

Hypertension (C) Signup and view all the answers

What is the most common cause of Cushing syndrome overall?

Iatrogenic administration of exogenous corticosteroids (C) Signup and view all the answers

Which hormone is responsible for glucose intolerance in Cushing syndrome?

Cortisol (D) Signup and view all the answers

What is the term for the accumulation of fat in the cervical area, characteristic of Cushing syndrome?

Buffalo hump (A) Signup and view all the answers

Which of the following is a clinical manifestation of Cushing syndrome?

Weight gain (C) Signup and view all the answers

What is the primary class of hormones involved in Cushing syndrome?

Corticosteroids (B) Signup and view all the answers

What is a priority for preoperative care?

Controlling hypertension, hyperglycemia, and hypokalemia (C) Signup and view all the answers

What is the purpose of administering high doses of corticosteroids during surgery?

To ensure adequate responses to the stress of the procedure (A) Signup and view all the answers

What is a sign of hypocortisolism after surgery?

Vomiting (C) Signup and view all the answers

Why is it important to monitor fluid intake and output after surgery?

To prevent fluid imbalance (B) Signup and view all the answers

What is a complication of rapid tapering of corticosteroids after surgery?

Acute adrenal insufficiency (B) Signup and view all the answers

What is a priority for postoperative care?

Monitoring BP, respirations, and heart rate (B) Signup and view all the answers

Why is bed rest usually recommended after surgery?

Until the BP stabilizes (D) Signup and view all the answers